Lymphedema

Lymphedema is a minimally known condition and requires a specialist to treat with the gold standard of care. Certified lymphedema therapists (CLT) are highly educated on the lymphatic system and have at least 134 hours of course work to become certified. The training consists of hours of education on the complicated lymphatic system, manual lymphatic drainage (MLD), compression bandaging and self-management of lymphedema.

Treatment after cancer can be traumatizing to the lymphatic vessels, causing them to decline in function. Even if lymphedema does not happen in every person who goes through cancer treatment, it does happen. The more lymph nodes removed, plus radiation therapy increases the likelihood of lymphedema. Onset of lymphedema is also common after having long term venous insufficiency (vein failure in the lower legs). The veins fail and the lymphatic system has to take over. This causes overload of the lymphatic system, causing lymphedema.

Proper lymphedema treatment is highly effective in treating and maintaining symptoms. Unfortunately, people are not referred to lymphedema therapists unless there is already visible lymphedema present. The education on what lymphedema is and how to prevent it is lacking in our medical system. The most ideal situation is for people to be referred right after surgery, to at least get education on prevention of infection and self-care and get a CLT on your care team.

Even if you do not have lymphedema, you should get education on the things to do and things to avoid. You should wear gloves while gardening or working in your yard to avoid cuts. If your arm had lymph nodes removed (even if its just sentinel node) there could still be a reduction of lymphatic function/immune response in the arm. Your arm could sense the cuts and scrapes as a big threat and create a large inflammatory response, causing lymphedema.

You should get an over the counter compression garment of 20-30mmHg to fly on an airplane. There have been too many people who come into the clinic with some lymph nodes removed and got on a plane without knowing the precautions. When they landed, they started to develop lymphedema a few days later. You can order a compression garment online or go to Just Like a Woman in S Portland or Transitions at Providence in NE Portland.

The last important note is to watch for sudden onset of patchy redness, swelling and pain which can be cellulitis. This is often after getting a scratch or cut in the extremity of the side of surgery. This is a medical emergency and you need to call your PCP immediately to get in or go to an urgent care for antibiotics. If you get cellulitis often, you will need a prescription of antibiotics on hand to take when you see these symptoms come on.

Lymphedema is a complicated condition, but with a CLT on your medical team, it can be managed very well.